Transoral Laser Surgery

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Head and Neck Cancer Treatment

The best method to treat head and neck tumors depends upon the location, and the size. Sometimes more than one treatment will work equally well, so the patient should have an opportunity to meet with doctors from different specialties before treatment begins in order to decide which option suits them best.
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Cancers of the head and neck are especially challenging to treat because these deep-seated tumors often arise in hard-to-reach areas such as the throat, mouth and larynx (voice box).

Minimally invasive surgery has provided a viable option to appropriate patients, resulting in a better quality of life following treatment.

The Head and Neck surgical team includes Neal Topham, MD, John A. Ridge, MD, and Miriam M. Lango, MD.

Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) is not for every patient, or for every cancer. Fox Chase head and neck surgeons Miriam N. Lango, MD, FACS, Jeffrey Liu, MD and John A. Ridge, MD, PhD, FACS will recommend the approach they believe best for you. Important factors such as the size and location of the tumor, and the presence of cancerous lymph nodes help them determine the best course of treatment. These surgeons not only have the expertise in performing a variety of traditional and minimally invasive surgical techniques, but they have the knowledge to choose the most effective technique for each patient.

How Transoral Surgery Works

There are several different kinds of transoral surgery: Transoral robotic surgery (TORS) and Transoral laser microsurgery (TLM). Both are minimally invasive methods of removing cancer in the tonsil, base of tongue or larynx, or voicebox. TORS is more often used to remove cancers in the tonsil and base of tongue, while TLM is usually used to remove cancers in the larynx. Each transoral approach has unique advantages.

Dr. Lango

Dr. Miriam Lango with the DaVinci Surgical System

During transoral surgery, the surgeon places a lighted viewing instrument into the patient's mouth, giving her access to the cancer from inside the body. No external incision is needed, minimizing the impact of the procedure on the patient.

During TORS, a camera and slender robotic arms are brought into position in the mouth, and the surgeon removes the entire cancer remotely. In contrast, during TLM, a surgeon will directly remove a cancer, often in several pieces by aiming the carbon dioxide laser at the cancer, observing every movement under a magnifying microscope.

Because there is little bleeding, the surgeons have a clear field of vision during the procedure. The tumor can be completely removed without affecting critical nerves and blood vessels. Patients generally experience less swelling and scarring and a lower risk of infection than is typical with conventional surgery.

Why Minimally Invasive Surgery is Beneficial

Patients who have the opportunity to undergo transoral laser surgery typically have a lower risk of some of the side effects that can occur, which might affect the ability to speak normally, breathe easily, swallow or eat solid food.

Transoral laser surgery does not require an incision, thus offering patients benefits over traditional, or open, surgery, including:

  • Greatly reduced risk of damage to facial structures, preserving function and appearance
  • Speedier and easier recovery, with faster return to work and daily life
  • No need for feeding tube or tracheotomy (a direct airway in the windpipe)
  • Shorter hospital stay and decreased need for narcotic pain medication
  • The surgeon can often cure cancer while preserving the best possible quality of life

One Patient's Experience

Charlie Osborne
Fox Chase surgeon, Miriam Lango, MD, treated Charlie Osborne's cancer of the larynx using a minimally invasive surgical technique.

One patient who benefited from this surgical technique is Charlie Osborne. In 2005, Osborne found out he had cancer of the larynx. After learning that he might be a candidate for laser surgery, he made an appointment with Dr. Lango.

Charlie decided to "bypass my local hospital and go straight to Fox Chase." Read Charlie's story.

Experienced Surgeons

Dr. Lango and Dr. Ridge work closely with plastic surgeon Neal S. Topham, MD, who specializes in reconstructive surgery and other techniques to achieve the best possible cosmetic and functional results for head and neck cancer patients. Meet our specially trained surgical team, all of whom are fellowship-trained and have expertise in all types of minimally invasive surgery.

For more information about cancer treatment and prevention at Fox Chase Cancer Center or to make an appointment, call 1-888-FOX CHASE (1-888-369-2427).